Evolution of the Modern American Health Care System

Today, the United States spends more on health care per capita than any other industrialized country, but many critics charge that American taxpayers are not getting enough bang for their health care bucks. Indeed, health care accounts for a major percentage of the nations gross domestic product, estimated at 17.8% in 2021, which was almost twice as much as the average Organization for Economic Co-operation and Development country. In fact, just 60 years ago, health care accounted for only 5% of the nations GDP (Nunn et al., 2020), and per capita health care expenditures in the United States today are almost twice as much per year compared to the nearest country, Germany, and a whopping four times higher compared to South Korea (Gunja et al., 2023). Nevertheless, most Americans are far more fortunate today compared to their counterparts from just a few decades ago when health care in the United States was less accessible and evidence-based and far more likely to result in suboptimal clinical outcomes. To determine how the nation reached this point, the purpose of this paper is to provide a review of the relevant literature concerning the evolution of the modern American health care system, including changes in medical expenditure, policy, and health care economics. Following this review, the paper provides a summary of the research and the significant findings that emerged from the literature in the conclusion.

Review and Discussion

The evolution of health care in the United States has been characterized by continued improvements in the delivery of services against a backdrop of capitalistic thinking that has created a unique health care system in the world today. For example, the bloody battlefields of the Civil War provided physicians of the era with unprecedented experience in surgical procedures and rehabilitative care which served to advance the profession in ways that would not have been possible otherwise. On the other hand, though, universal health care remains out of reach for far too many Americans today. In this regard, Griffin (2020) reports that, While the Civil war propelled the progress of American medicine much faster than what would have probably transpired without it, our staunch belief in capitalism has prevented us from developing national healthcare (para. 3). Consequently, the evolution of the modern American health care system has created a uniquely hybrid model that stands apart from other affluent nations. As Griffin points out, We have our own unique system that has evolved drastically over the past century into something that is both loved and hated by its citizens (2020, para. 4).

These mixed opinions are readily understandable given the high stakes that are involved, but the fact remains that the nations health care network has undergone incremental changes and gradual improvements, most especially since the fin de sicle. Moreover, there have also been fundamental changes in the way doctors and other health care practitioners have been paid over the past two hundred...

…are cultural and social priorities that have also played a role in shaping the nations health care system over the past half century (Conklin, 2002). The introduction of Medicare and Medicaid in 1965 helped make health care services more affordable and accessible for low-income consumers as well as the elderly and disabled (Baldwin, 2021).

More recently, managed care plans became more prevalent during the 1980s and 1990s which served to control health care costs but also limited patient choice in some cases. Likewise, there was also an expansion of employer-sponsored health insurance which resulted in a shift away from direct payment by patients for healthcare services. Finally, the Affordable Care Act was passed in 2010 which expanded access to health insurance coverage, required individuals to have health insurance, and implemented various cost-containment measures (Kim, 2022).

Conclusion

The research showed that the evolution of the US healthcare system has been marked by a series of policy changes, economic transformations, and technological advancements. While progress has been made in expanding access to healthcare coverage and improving the quality of care, relentlessly rising health care costs remain a significant challenge for policymakers, providers, and patients alike. In the final analysis, it is reasonable to conclude that U.S. taxpayers will continue to pay far more for their health care services that their counterparts in other industrialized nations unless and until lawmakers take substantive action to effect the meaningful changes that are needed to reduce costs and improve accessibility for all American health care…